Proudly serving San Antonio since 1994
Patient Forms
Please fill out forms, print and take with you to your appointment. If you do not already have Acrobat Reader please click here to download the latest free version that will work on your computer.
Patient History - New Patient Form
Patient History - Follow Up Form
The Tejas Anesthesia, P.A. Notice of Privacy Practices will be posted here and available for our patients to view. The copy posted on this Web site will be updated so you will be able to find the current version of this document. This document is available in Adobe Acrobat format. If you do not already have Acrobat Reader please click here to download the latest free version that will work on your computer.
The Acknowledgment of Receipt of Notice of Privacy Practices is posted here so you can view, fill in your name and the current date online, print, and sign so we can place this Acknowledgment in your records. Or you can view and then print the Acknowledgment, fill in your name, date, and sign with a pen. After you print the document you can click the Reset Button at the top of the form to remove your name from the online form. This document is available in Adobe Acrobat format. If you do not already have Acrobat Reader please click here to download the latest free version that will work on your computer.
Referral Forms
MVA Insurance Verification Form
Worker's Compensation Insurance Verification Form
HMO Insurance Verification Form
PPO Insurance Verification Form
If you do not already have Acrobat Reader please click here to download the latest free version that will work on your computer.
Tejas Anesthesia, P.A. offers and maintains this Web site to provide information of a general nature about the conditions requiring the services of an anesthesiologist. The information is provided with the understanding that Tejas Anesthesia, P.A. is not engaged in rendering surgical or medical advice or recommendations. Any information in the publications, messages, postings, or articles on this Web site should not be considered a substitute for consultation with a (board certified) anesthesiologist to address individual medical needs. Individual facts and circumstances will determine the treatment that is most appropriate. This information is meant for residents of the state of Texas and any others who read it do so at their own risk. Send mail to info@tejas-anesthesia.com with questions or comments about Tejas Anesthesia, P.A.